PDF(Pubmed)
Abstract：
UNASSIGNED: Many studies have pointed out that iron overload in the body is a risk factor for coronary atherosclerosis (AS), while there are also studies that show that iron deficiency is associated with coronary AS. There is still no consensus on how iron metabolism affects coronary artery disease (CAD). This study aimed to analyze the relationship between iron metabolism indexes and CAD, investigate the diagnostic value of soluble transferrin receptor (sTfR) in suspected CAD, and establish a diagnostic model.
UNASSIGNED: This was a retrospective study. A total of 268 people with CAD-like symptoms who underwent coronary angiography in the Department of Cardiovascular Medicine, The Second Affiliated Hospital of Anhui Medical University from September 2022 to May 2023 without other chronic diseases or related medication history were included in the study and formed a continuous series including 188 CAD patients and 80 control subjects. Each iron metabolism index was divided into a grade variable according to tertile. The comparison of CAD morbidity between the tertiles and nonlinear correlation test was conducted to investigate the relationship between iron metabolism indexes and CAD risk. We used restricted cubic spline (RCS) to plot the relationship curve between sTfR and CAD risk and to determine the sTfR value corresponding to the minimal odds, according to which we divided the total sample into the \"sTfR low level\" subgroup and the \"sTfR high level\" subgroup. Logistic regression analyses were used to establish diagnostic models in both subgroups. The diagnostic efficiency of the indexes and models was compared by receiver operating characteristic (ROC) analysis.
UNASSIGNED: There is a \"J\" shape correlation between sTfR and CAD risk. Age/sTfR ratio [area under the curve (AUC) =0.690, 95% confidence interval (CI): 0.598-0.782, specificity 0.488 and sensitivity 0.842] has the best diagnostic efficiency in the \"sTfR low level\" subgroup. The diagnostic efficiency of sTfR (AUC =0.701, 95% CI: 0.598-0.803, specificity 0.541 and sensitivity 0.797) in the \"sTfR high level\" subgroup was higher than that of cardiac troponin I (cTnI) (AUC =0.674, 95% CI: 0.564-0.784, specificity 0.719 and sensitivity 0.653). The specific diagnostic methods were as follows: (I) When sTfR ≤1.087 mg/L, calculate the age/sTfR ratio, which indicates the diagnosis of CAD when the result is >58.595; (II) We can directly make a preliminary clinical diagnosis of CAD when sTfR >1.205 mg/L. Except for the above 2 cases, we can initially rule out a diagnosis of CAD.
UNASSIGNED: The iron metabolism index sTfR correlates with CAD morbidity in a \"J\" shape. With superior diagnostic efficacy than cTnI, sTfR can assist in diagnosing CAD in patients with CAD-like symptoms. In addition, sTfR can provide guidance for the management of body iron levels in CAD patients.
UNASSIGNED: This was a retrospective study. A total of 268 people with CAD-like symptoms who underwent coronary angiography in the Department of Cardiovascular Medicine, The Second Affiliated Hospital of Anhui Medical University from September 2022 to May 2023 without other chronic diseases or related medication history were included in the study and formed a continuous series including 188 CAD patients and 80 control subjects. Each iron metabolism index was divided into a grade variable according to tertile. The comparison of CAD morbidity between the tertiles and nonlinear correlation test was conducted to investigate the relationship between iron metabolism indexes and CAD risk. We used restricted cubic spline (RCS) to plot the relationship curve between sTfR and CAD risk and to determine the sTfR value corresponding to the minimal odds, according to which we divided the total sample into the \"sTfR low level\" subgroup and the \"sTfR high level\" subgroup. Logistic regression analyses were used to establish diagnostic models in both subgroups. The diagnostic efficiency of the indexes and models was compared by receiver operating characteristic (ROC) analysis.
UNASSIGNED: There is a \"J\" shape correlation between sTfR and CAD risk. Age/sTfR ratio [area under the curve (AUC) =0.690, 95% confidence interval (CI): 0.598-0.782, specificity 0.488 and sensitivity 0.842] has the best diagnostic efficiency in the \"sTfR low level\" subgroup. The diagnostic efficiency of sTfR (AUC =0.701, 95% CI: 0.598-0.803, specificity 0.541 and sensitivity 0.797) in the \"sTfR high level\" subgroup was higher than that of cardiac troponin I (cTnI) (AUC =0.674, 95% CI: 0.564-0.784, specificity 0.719 and sensitivity 0.653). The specific diagnostic methods were as follows: (I) When sTfR ≤1.087 mg/L, calculate the age/sTfR ratio, which indicates the diagnosis of CAD when the result is >58.595; (II) We can directly make a preliminary clinical diagnosis of CAD when sTfR >1.205 mg/L. Except for the above 2 cases, we can initially rule out a diagnosis of CAD.
UNASSIGNED: The iron metabolism index sTfR correlates with CAD morbidity in a \"J\" shape. With superior diagnostic efficacy than cTnI, sTfR can assist in diagnosing CAD in patients with CAD-like symptoms. In addition, sTfR can provide guidance for the management of body iron levels in CAD patients.
摘要：
■许多研究指出，体内铁超负荷是冠状动脉粥样硬化（AS）的危险因素，同时也有研究表明铁缺乏与冠状动脉AS相关。关于铁代谢如何影响冠状动脉疾病（CAD）仍未达成共识。本研究旨在分析铁代谢指标与CAD的关系。探讨可溶性转铁蛋白受体(sTfR)在疑似冠心病中的诊断价值,并建立诊断模型。
■这是一项回顾性研究。共有268名患有CAD样症状的人在心血管内科接受了冠状动脉造影，将2022年9月至2023年5月期间无其他慢性病或相关用药史的安徽医科大学第二附属医院纳入本研究，并形成包括188例CAD患者和80例对照受试者的连续系列。每个铁代谢指标根据三元组分为一个等级变量。比较三元组和非线性相关检验的CAD发病率，以探讨铁代谢指标与CAD风险之间的关系。我们使用限制三次样条（RCS）绘制sTfR和CAD风险之间的关系曲线，并确定与最小赔率相对应的sTfR值，根据我们将总样本分为“sTfR低级别”子组和“sTfR高级别”子组。采用Logistic回归分析建立两个亚组的诊断模型。通过受试者工作特性（ROC）分析比较了指标和模型的诊断效率。
■sTfR和CAD风险之间存在“J”形状相关性。年龄/sTfR比值[曲线下面积(AUC)=0.690,95%置信区间(CI):0.598-0.782,特异性0.488和灵敏度0.842]在“sTfR低水平”亚组中具有最佳诊断效率。“sTfR高水平”亚组sTfR的诊断效率（AUC=0.701，95％CI：0.598-0.803，特异性0.541和敏感性0.797）高于心肌肌钙蛋白I（cTnI）（AUC=0.674，95％CI：0.564-0.784，特异性0.719和敏感性0.653）。具体诊断方法如下:(I)当sTfR≤1.087mg/L时,计算年龄/sTfR比率，当结果>58.595时，表明CAD的诊断；（II）当sTfR>1.205mg/L时，我们可以直接进行CAD的初步临床诊断。除上述两种情况外，我们可以初步排除CAD的诊断。
■铁代谢指数sTfR与CAD发病率呈“J”形相关。诊断效能优于cTnI，sTfR可以帮助诊断有CAD样症状的患者的CAD。此外,sTfR可以为CAD患者体内铁水平的管理提供指导。
■这是一项回顾性研究。共有268名患有CAD样症状的人在心血管内科接受了冠状动脉造影，将2022年9月至2023年5月期间无其他慢性病或相关用药史的安徽医科大学第二附属医院纳入本研究，并形成包括188例CAD患者和80例对照受试者的连续系列。每个铁代谢指标根据三元组分为一个等级变量。比较三元组和非线性相关检验的CAD发病率，以探讨铁代谢指标与CAD风险之间的关系。我们使用限制三次样条（RCS）绘制sTfR和CAD风险之间的关系曲线，并确定与最小赔率相对应的sTfR值，根据我们将总样本分为“sTfR低级别”子组和“sTfR高级别”子组。采用Logistic回归分析建立两个亚组的诊断模型。通过受试者工作特性（ROC）分析比较了指标和模型的诊断效率。
■sTfR和CAD风险之间存在“J”形状相关性。年龄/sTfR比值[曲线下面积(AUC)=0.690,95%置信区间(CI):0.598-0.782,特异性0.488和灵敏度0.842]在“sTfR低水平”亚组中具有最佳诊断效率。“sTfR高水平”亚组sTfR的诊断效率（AUC=0.701，95％CI：0.598-0.803，特异性0.541和敏感性0.797）高于心肌肌钙蛋白I（cTnI）（AUC=0.674，95％CI：0.564-0.784，特异性0.719和敏感性0.653）。具体诊断方法如下:(I)当sTfR≤1.087mg/L时,计算年龄/sTfR比率，当结果>58.595时，表明CAD的诊断；（II）当sTfR>1.205mg/L时，我们可以直接进行CAD的初步临床诊断。除上述两种情况外，我们可以初步排除CAD的诊断。
■铁代谢指数sTfR与CAD发病率呈“J”形相关。诊断效能优于cTnI，sTfR可以帮助诊断有CAD样症状的患者的CAD。此外,sTfR可以为CAD患者体内铁水平的管理提供指导。
